Founder & CEO, Sherpaa

Health insurance companies are the lowest of the low.

CALIFORNIA: With only one vote to spare the state Senate approved a bill that allows greater access to cost and quality transparency in health care, a bill for which Aetna took a lead role in advocating. The measure would ban hospitals and providers from precluding health insurers to disclose cost and quality information to its members. A few large hospital systems are using their market presence and negotiation power to require gag clauses in contracts with insurers that restrict them from releasing cost and quality information about their providers or facility. The bill moves to the Assembly where the hospital and physician lobby is even stronger. However, Aetna is gaining support in the employer community and among consumer groups, such as AARP, which support the bill.

Aetna is essentially forcing physicians to expose their prices and using the government to do so. I used to be a strong proponent of physician price transparency (not physicians in general, but only primary care physicians – I could give a damn about some interventional cardiologist making $600K a year bitching about how the system and malpractice rates are so unfair). But the real issue is once primary care docs do expose their prices, the goddamn insurance companies have the upper hand in negotiating contracts for how much docs get reimbursed. This means that insurance companies would have primary care docs even more by the balls and we’d be powerless to negotiate better reimbursement rates.

The kicker is this. Aetna heavily guards how much they reimburse doctors for visits and procedures. But they’re going through the government to force doctors to expose their prices ALL IN THE NAME OF A FALSE CONSUMERISM. Until people have to spend their own money to purchase medical care (not a meaningless $5 co-pay), “consumers” aren’t going to care about how much anything costs. They’re not going to be true consumers.

The consumerism movement cannot begin with physician price transparency. It must begin with healthcare users purchasing goods and services with their own money – just like car insurance. If it begins with physician price transparency, the rape of primary care doctors will continue and worsen.